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1.
Turk J Phys Med Rehabil ; 68(2): 290-294, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35989957

ABSTRACT

Studies suggest that exercise regimens are beneficial across all phases of cancer treatment and rehabilitation. However, studies on the efficacy and safety of cardiac rehabilitation in patients with chemotherapy-related cardiomyopathy are lacking. Herein, we present two patients diagnosed with chemotherapy-related cardiomyopathy who participated in a cardiac rehabilitation program, including eight weeks of high-intensity interval training, and their exercise capacity was monitored. Both patients showed significant increases in peak oxygen consumption and 6-min walk distance. High-intensity interval training results in objective improvements in aerobic exercise capacity without serious cardiovascular complications in patients with chemotherapy-related cardiomyopathy.

2.
Cancers (Basel) ; 14(3)2022 Jan 22.
Article in English | MEDLINE | ID: mdl-35158827

ABSTRACT

BACKGROUND: We evaluated the safety and efficacy of direct oral anticoagulants (DOACs) versus subcutaneous dalteparin for cancer-associated venous thromboembolism (CA-VTE) in patients with advanced upper gastrointestinal (GI) tract, hepatobiliary, or pancreatic cancer. METHODS: This was a multicenter, randomized, open-label, phase II trial in five centers. Patients randomly received rivaroxaban (15 mg twice daily for 3 weeks, then 20 mg once daily)/apixaban (10 mg twice daily for the first 7 days, then 5 mg twice daily) or dalteparin (200 IU/kg once daily for the first month, then 150 IU/kg once daily). Randomization was stratified by the Eastern Cooperative Oncology Group Performance Status, primary cancer type, active chemotherapy, and participating centers. The primary endpoint was the rates of clinically relevant bleeding (CRB) in the full analysis set (FAS). RESULTS: A total of 90 patients were randomly assigned to the DOAC (n = 44) and dalteparin groups (n = 46) in FAS. CRB and major bleeding (MB) rates were 34.1% and 13.0% (p = 0.018) and 18.2% and 4.3% (p = 0.047) for the DOAC and dalteparin groups, respectively. Time to CRB and MB was higher in the DOAC group than in the dalteparin group (hazard ratio [HR] 2.83; p = 0.031 and HR 4.32; p = 0.064). Cancer involvement at the GI mucosa was also a significant risk factor for CRB. Recurrent CA-VTE occurred in 2.3% and 2.2% of patients given DOAC and dalteparin, respectively (p = 1.000). CONCLUSION: DOAC therapy further increased the risk of bleeding compared with dalteparin in patients with active advanced upper GI tract, hepatobiliary, or pancreatic cancer, suggesting that extra caution should be taken when selecting anticoagulants for CA-VTE.

3.
Ther Adv Med Oncol ; 11: 1758835919871126, 2019.
Article in English | MEDLINE | ID: mdl-31489036

ABSTRACT

BACKGROUND: Liposomal irinotecan (nal-IRI) plus 5-fluorouracil and leucovorin (5-FU/LV) was effective and well-tolerated in patients with metastatic pancreatic adenocarcinoma (mPAC) that progressed on gemcitabine-based therapy in the global NAPOLI-1 trial. Real-world data may further clarify the outcomes and safety profile of nal-IRI + 5-FU/LV in clinical practice. METHODS: This retrospective analysis included patients with mPAC who received nal-IRI + 5-FU/LV following gemcitabine-based therapy under a Managed Access Program in Korea. RESULTS: From January 2017 to April 2018, 86 patients across 10 institutions received nal-IRI + 5-FU/LV (median age, 61 years; 60% male; ECOG performance status, 0-1). A total of 35 (41%) and 51 (59%) patients had received less than two and two or more lines of chemotherapy before inclusion, respectively. At a median follow up of 6.4 months, median overall survival (OS) was 9.4 months (95% confidence interval [CI] 7.4-11.4) and median progression-free survival (PFS) was 3.5 months (95% CI 1.3-5.7). Six-month OS and PFS rates were 65.1% and 37.5%, respectively. Objective response and disease control rates were 10% and 55%, respectively. Most common grade 3-4 toxicities were neutropenia (37.2%), nausea (10.5%), vomiting (9.3%), anorexia (8.1%) and diarrhoea (4.7%). CONCLUSION: Real-life data for Korean patients indicate that, consistent with NAPOLI-1, nal-IRI + 5-FU/LV is effective and well-tolerated in patients with mPAC that progressed on gemcitabine-based therapy.

4.
J Sport Rehabil ; 28(3): 229-235, 2019 Mar 01.
Article in English | MEDLINE | ID: mdl-28952870

ABSTRACT

CONTEXT: The infraspinatus muscle plays a particularly important role in producing primary external rotation (ER) torque and dynamic stability of the shoulder joint. Previous studies have reported that prone external rotation with horizontal abduction (PER), side-lying wiper exercise (SWE), and standing external rotation (STER) were effective exercises for strengthening the infraspinatus. However, we do not have enough knowledge about changes in muscle strength and dynamic muscle activity in each exercise under dynamic conditions. OBJECTIVE: To compare the ER muscle strength, muscle activity among exercise methods and between muscle contraction types during 3 different exercises. DESIGN: Repeated measures design in which ER muscle strength and muscle activities data were collected from subjects under 3 exercise conditions. SETTING: Outpatient clinic. PARTICIPANTS: A total of 15 healthy men with no shoulder, neck, or upper-extremity pain were participated. INTERVENTION: The subjects performed 3 different exercises randomly in concentric and eccentric using a Biodex dynamometer at an angular velocity of 60°/s. MAIN OUTCOME MEASURES: The ER peak torque (PT) data was collected and surface electromyography was used to measure the activity of the infraspinatus and posterior deltoid muscles and infraspinatus to posterior deltoid muscle activity ratio. RESULTS: There was significant main effect for muscle contraction type in ER PT (P < .05). The concentric PT was greater during PER (P < .05) and SWE (P < .05) compared with eccentric. The main effect for exercise was found in ER PT and muscle activity (P < .05). The ER PT and infraspinatus muscle activity were the largest increased during PER whereas the lowest during STER in both concentric and eccentric (P < .05). CONCLUSION: The results of this study suggest that PER is an exercise for strengthening the infraspinatus muscle effectively.


Subject(s)
Exercise Therapy , Muscle Strength , Rotator Cuff/physiology , Shoulder/physiology , Adult , Electromyography , Humans , Male , Muscle Strength Dynamometer , Rotation , Torque
5.
J Phys Ther Sci ; 28(8): 2373-5, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27630435

ABSTRACT

[Purpose] The purpose of this study was to investigate the effect of isometric hip adduction and abduction on trunk muscle activity during plank exercises. [Subjects and Methods] Nineteen healthy male subjects were recruited for this study. All subjects performed the traditional plank exercise (TP), plank exercise with isometric hip adduction (PHAD), and plank exercise with isometric hip abduction (PHAB) by using an elastic band. Electromyographic (EMG) activities of the internal oblique (IO) and external oblique (EO) were measured during the 3 plank exercises by using an Electromyography system. [Results] Internal oblique and external oblique muscle activities were significantly greater during plank exercise with isometric hip adduction and plank exercise with isometric hip abduction than during traditional plank exercise. Internal oblique and external oblique muscle activities did not differ between the plank exercise with isometric hip adduction and plank exercise with isometric hip abduction conditions. [Conclusion] These findings demonstrate that loaded isometric hip movements may be a useful strategy to increase trunk muscle activity during plank exercises.

6.
Int J Pediatr Otorhinolaryngol ; 79(8): 1337-40, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26100056

ABSTRACT

OBJECTIVE: A fibrinogen/thrombin-based collagen fleece (TachoComb) is a powerful topical hemostatic agent that has been widely used in various surgical specialties with a favorable outcome. The purpose of this study was to investigate the effect of TachoComb application on postoperative complications after tonsillectomy. MATERIALS AND METHODS: A total of 1633 children had undergone tonsillectomy with or without adenoidectomy were included in this study. After removal of both tonsils, 1057 patients (64.7%) were treated with TachoComb on the tonsillectomy site and 576 without TachoComb. Post-tonsillectomy pain, hemorrhage rates, re-admission rates, and emergency surgery rates for post-tonsillectomy hemorrhage were evaluated between patients who received TachoComb and those who did not. RESULTS: TachoComb treatment significantly reduced post-tonsillectomy pain and emergency surgery rates for post-tonsillectomy hemorrhage. However, postoperative hemorrhage rate and re-admission rates for post-tonsillectomy hemorrhage were not statistically significant between TachoComb treatment group and control group. No patients had complications or adverse reactions after TachoComb treatment. CONCLUSIONS: The use of TachoComb after tonsillectomy significantly reduces pain and emergency surgery for severe post-tonsillectomy hemorrhage without an apparent adverse effect. Therefore, TachoComb may be a useful adjuvant in terms of efficacy and safety after tonsillectomy.


Subject(s)
Aprotinin/therapeutic use , Fibrinogen/therapeutic use , Hemostasis, Surgical/methods , Hemostatics/therapeutic use , Pain, Postoperative/prevention & control , Postoperative Hemorrhage/prevention & control , Thrombin/therapeutic use , Tonsillectomy , Adenoidectomy , Adolescent , Child , Child, Preschool , Drug Combinations , Female , Humans , Male , Retrospective Studies , Treatment Outcome
7.
Am J Hematol ; 86(5): 399-405, 2011 May.
Article in English | MEDLINE | ID: mdl-21523798

ABSTRACT

The impact of reduced-intensity conditioning (RIC) on the outcomes of hematopoietic cell transplantation (HCT) from unrelated -donors (UD) remains to be determined. We therefore assessed 128 patients, aged 16 to 66 years, with acute leukemia (n = 105) or myelodysplastic syndrome (n = 23) in a UD-HCT trial using RIC with busulfan, fludarabine, and antithymocyte globulin. Patients were transplanted with unmanipulated bone marrow (BM, n = 41) or mobilized peripheral blood mononuclear cells (M-PB, n = 87) and received cyclosporine and methotrexate for graft-versus-host disease (GVHD) prophylaxis. After a median follow-up of 26.7 months (range, 5.9-70.7 months) in surviving patients, 19 patients had died without progression/recurrence of underlying disease, giving a cumulative incidence of transplantation-related mortality (TRM) of 17% (95% confidence interval, 11%-27%; 1-year TRM, 14%). Graft failure (n = 7) and infections (n = 5) were the most common causes of TRM. Only three patients died due to GVHD (acute, one; chronic, two). Graft failure, which occurred in eight patients, showed a significant correlation with graft source (BM, 6/41 vs. M-PB, 2/87; P = 0.009). Donor-patient HLA-disparity did not correlate with GVHD, 1-year TRM, and graft failure. RIC containing antithymocyte globulin led to decreased GVHD-associated, as well as overall, TRM after UD-HCT.


Subject(s)
Antilymphocyte Serum/therapeutic use , Hematopoietic Stem Cell Transplantation/mortality , Immunosuppressive Agents/therapeutic use , Transplantation Conditioning/methods , Adolescent , Adult , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Bone Marrow Transplantation/adverse effects , Bone Marrow Transplantation/mortality , Busulfan/administration & dosage , Busulfan/therapeutic use , Graft Survival/drug effects , Graft vs Host Disease/prevention & control , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Leukemia, Myeloid, Acute/therapy , Medical Records , Middle Aged , Myelodysplastic Syndromes/therapy , Peripheral Blood Stem Cell Transplantation/adverse effects , Peripheral Blood Stem Cell Transplantation/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Retrospective Studies , Survival Analysis , Vidarabine/analogs & derivatives , Vidarabine/therapeutic use , Young Adult
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